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Deleted Code. For computer-assisted navigational procedures with image guidance based on pre-operative and intraoperatively obtained images, see 0054T, 0055T)

Official Description

Computer-assisted surgical navigational procedure for musculoskeletal procedures; with image guidance based on preoperative images (List separately in addition to code for primary procedure)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 20987 refers to a computer-assisted surgical navigational procedure specifically designed for musculoskeletal surgeries, utilizing image guidance based on preoperative images. This procedure is performed either prior to or during complex musculoskeletal surgeries, such as those involving the fixation of femoral or pelvic fractures. The primary advantage of employing computer-assisted surgical navigation is the enhancement of surgical accuracy, which is critical in minimizing complications and improving patient outcomes. By allowing surgeons to operate through smaller incisions, this technique not only reduces the overall surgery time and blood loss but also contributes to a shorter postoperative rehabilitation period for patients. The process of computer-assisted surgical navigation is structured into three key steps: data acquisition, registration, and tracking. During data acquisition, image-less navigation gathers information related to the centers of joint rotation and utilizes visual cues, such as anatomical landmarks. Following this, registration techniques are employed to correlate the image-less anatomical data with the bony anatomy present in the surgical field. A computer-generated model is then created from the anatomical information and aligned with the surface data points collected during the surgical procedure. Finally, tracking is conducted using specialized sensors and measurement devices that provide real-time feedback to the surgeon regarding the accurate placement of surgical instruments in relation to the bony anatomy. It is important to note that for intraoperative image-guided computer-assisted surgical navigation, CPT® Code 20986 should be used, while CPT® Code 20987 is designated for preoperative image-guided navigation. In contrast to image-less systems, image-guided navigational systems utilize radiographic techniques such as fluoroscopy, ultrasound, CT, or MRI to acquire data, which is then integrated with the computer-assisted navigation systems to ensure precise tracking of surgical tools during the procedure.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The computer-assisted surgical navigational procedure (CPT® Code 20987) is indicated for use in complex musculoskeletal surgeries where enhanced precision is required. This includes, but is not limited to, the following conditions:

  • Complex Fractures - Procedures involving the fixation of complex fractures, such as femoral or pelvic fractures, where accurate placement of hardware is critical.
  • Joint Reconstruction - Surgeries aimed at reconstructing damaged joints that require precise alignment and positioning of surgical instruments.
  • Spinal Surgery - Interventions on the spine that necessitate exact navigation to avoid critical structures and ensure proper placement of implants.

2. Procedure

The computer-assisted surgical navigational procedure involves a systematic approach broken down into three essential steps:

  • Data Acquisition - In this initial phase, image-less navigation gathers critical information related to the centers of joint rotation and visual cues from anatomical landmarks. This data is essential for creating a reference framework for the surgical procedure.
  • Registration - Following data acquisition, registration techniques are employed to correlate the image-less anatomical data with the actual bony anatomy present in the surgical field. This step ensures that the computer-generated model accurately reflects the patient's unique anatomy.
  • Tracking - The final step involves tracking the surgical instruments using sensors and measurement devices. This technology provides real-time feedback to the surgeon, ensuring that the placement of surgical tools is accurate in relation to the bony anatomy throughout the procedure.

3. Post-Procedure

After the completion of the computer-assisted surgical navigational procedure, standard post-operative care protocols should be followed. This includes monitoring the patient for any signs of complications, managing pain, and ensuring proper wound care. The use of this advanced navigational technique is expected to lead to a reduced recovery time, allowing for a quicker return to normal activities. Additionally, patients may benefit from a tailored rehabilitation program that takes into account the specific nature of their surgery and the precision achieved through the navigational procedure.

Short Descr CPTR-ASST DIR MS PX PRE IMG
Medium Descr CPTR-ASST DIR MS PX PRE IMG
Long Descr CPTR-ASST SURG NAVIGATION PREOPERATIVE IMAGE
APC Status Indicator Items and Services Packaged into APC Rates
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 164 - Other OR therapeutic procedures on musculoskeletal system
Date
Action
Notes
2009-01-01 Deleted Deleted Code. For computer-assisted navigational procedures with image guidance based on pre-operative and intraoperatively obtained images, see 0054T, 0055T)
2008-01-01 Added Code added.
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